How can I make more breastmilk?

The question of increasing your breastmilk supply is one that comes up quite frequently. I think at some point in your nursing journey, every mother asks herself this question.

What we should rather be asking ourselves is this, "Why do I think I need more milk and is my supply really low?".

Often mothers will be under the misconception that they don't have enough milk and that there's an issue that needs fixing.

If you increase your supply when you actually do already have enough milk, it can lead to an over-supply which brings with it various complications and issues for yourself and your baby.

Some of the most common reasons mothers doubt their supplies are usually;

Baby is constantly nursing and doesn't seem satisfied at the breast.

When mom tries to pump out milk to see how much baby is getting, she doesn't yield much result.

Her breasts don't feel as full and engorged like they did in the beginning.

None of these are actual indications of low milk supply and can usually be explained as;

1. Why baby is constantly nursing and doesn't seem satisfied at the breast;

Most mothers are surprised to learn how often their babies are actually supposed to be nursing and did not expect their lives to resolve around breastfeeding. They often have the idea that maternity leave will be a wonderful relaxing holiday with lots of time for activities.

But when they find themselves nursing their baby every 2 hours and sometimes even every 30 minutes, they think surely something must be wrong and it's the milk to get the blame. The reality is that newborns need to nurse a minimum of 10 to 12 times in 24 hours and most babies want to nurse more frequently than that. So if you calculate it, your baby should be nursing at least every 1 hour and 30 minutes to 2 hours during the day and every 3 hours during the night. If your baby is under 6 weeks of age, you should be waking them for night feeds.

Breastmilk digests within 90 minutes and nursing sessions can range anything from 20 minutes up to 1 hour +. Yes, you read that right, your baby can be attached to the boob for more than an hour at a time! This is completely normal, especially during growth spurts and wonder weeks when all they want to do is nurse. (Remember that you time a nursing session from the start of the session, irregardless of how long baby nursed. So if baby was attached at the breast for 45 minutes, you need to be offering a feed 45 minutes after you finished already)

2. Why moms can't pump much milk but baby is still getting enough;

All moms would love the reassurance of knowing exactly how many ml's of milk baby drank. Nature doesn't work that way. When mothers then turn to the pump to tell them how much milk they have, they are almost always alarmed.

Just because you are not pumping much milk, or even any milk, does not mean you don't have milk. Thing is, your body does not respond to a pump the way it does to your baby. Babies are far more effective at removing milk than any pump will ever be, this is because we love our babies, we don't love our pumps.

For a let-down to occur, meaning for your milk to be released from your body, there needs to be a chemical reaction in your brain and oxytocin (the love hormone) needs to be released. This is why most pumping mothers need to play video clips of their babies, listen to recordings of their babies crying and smell items of clothing their baby wore to trigger let-downs while pumping at work.

3. Why breasts stop feeling engorged;

When you first have your baby, your production is hormone driven. Your body just keeps making milk because it has no idea yet of how much your baby actually needs. It's just so scared of not making enough so it keeps on running the factory and you become engorged.

Engorgement is when your breasts are overly full, hard and often sore. This is common after birth but around 6 weeks postpartum, your supply starts to stabilize and your milk production has started to switch over to the supply and demand system. This means that the more milk is removed from your breasts (demand), the more milk they make (supply).

Thus around 6 weeks when your supply has stabilized, your breasts aren't supposed to feel full or engorged, it doesn't mean the milk has gone anywhere, it just means your body now knows how much your baby needs and makes just enough for your baby at that time. So as baby grows, your milk will steadily adapt in fat content and not volume.

Identifying a low supply:

Before we discuss how you can increase your breastmilk supply, it's important that we first determine if you do have a low supply. Because if you increase your supply when you actually do already have enough milk, it can lead to an over-supply which brings with it various complications and issues for yourself and your baby.

Questions 1: Is my baby getting enough milk?

We determine this by looking at the wet nappy output in a 24h period. For babies newborn to 6 weeks, it should be 5 to 6 wet diapers in 24 hours and for babies 6 weeks and olfer, it's 4 to 5 sopping wet diapers in 24 hours.

Question 2: Is my baby happy and content between feeds?

Newborns usually nurse, fall asleep at the breast and then wake up to nurse again. There's no real play time for them and only as they get older, do they have periods of being awake and making meaningful interaction.

If you catch your baby's early hunger cues before they reach the last critical hunger cue, which is crying, to alert you that you missed the hunger cues, your baby doesn't have to cry often if at all. You can also look at your baby's hands while they sleep, they usually have open and relaxed hands when they fell asleep at the breast with a full tummy.

Now I'm not saying your baby will never be fussy or cry, because during growth spurts and wonder weeks they can get extremely fussy and it is usually during these times that mothers start to doubt their milk.

Questions 3: Is my baby gaining sufficient weight according to his own unique growth curve?

You'll notice I didn't put this one first. The weight gain is not the mot important aspect to look at, it needs to be assesed with all the other aspects to see the bigger picture. When we know baby is having sufficient wet nappies, we know baby is getting enough milk and that baby could just be a slow gainer or be petite due to genetics.

What you want to see from your baby's growth curve is a positive growth, even if small. We only start to worry when there is a negative / downwards curve in the line. When older babies start crawling or walking there's also usually a plateau where the line doesn't increase for a while.

Question 4: Do I hear my baby actively sucking and swallowing during feeds?

Don't worry about not being able to feel your let-down, not all mothers do. Rather try to focus on listening to your baby to hear and see swallowing every couple of seconds. Your milk doesn't constantly spray out, it's a dance between baby and breast.

Baby gives short fluttery sucks to trigger a let-down, then there's a pause waiting for the let-down, your body responds by releasing a burst of milk, baby gives deep strong sucks as he swallows the milk, then back to short fluttery sucks to trigger the next let-down.

Question 5: Do my breasts feel softer after a nursing session?

We've already discussed that your breasts won't feel engorged or hard after 6 weeks but you may still be able to feel some pressure or gathering of milk when you touch or squeeze them. Usually after a nursing session they will feel a bit softer.

This one is probably the least important, because often mothers can't determine when the breasts feel fuller and report that they always feel empty, especially when recalling how they felt directly after birth when their milk came in.

No I don't actually have low supply:

If you can answer yes to the above questions, then you don't need to increase your supply because;

You do have sufficient milk

Baby is accessing the milk

Baby is effectively nursing and emptying the breast.

Yes I do have a low supply:

If you still think that you don't have sufficient milk and you have identified a problem, your first step in addressing the issue would be to call your closest La Leche League Leader or IBCLC for a consult.

If baby is not having sufficient wet diapers, is not content between feeds, not gaining sufficient weight, you can't hear him swallowing and your breasts aren't being drained, it's important to rule out any medical conditions and reasons. For instance, they'll need to determine if baby has a tongue tie that prevents him form nursing effectively and acceding the milk.

If top-ups are needed for a baby that's not gaining sufficient weight, you'll need to pump and offer breastmilk top-ups via cup or syringe after nursing sessions, while you work on increasing your supply or tend to the medical reason.

How to increase your breastmilk supply:

If you've determined that you do have a low supply, you can increase it by increasing the demand. As explained, your breasts produce milk on the supply and demand system. The more milk is removed from your breasts, the more milk you'll make.

This is where the phrase comes from that says "full breasts don't make milk", because when your breasts are full, they tell your body "Okay guys, we have enough now, baby doesn't need more at this stage, lets take a break".

You can increase the demand by;

Offering baby extra nursing sessions.

Pumping your breasts completely empty after each nursing session. (Your breasts also follow the 80/20 rule when making milk. 80% is what baby needs and 20% is extra. By draining the extra 20%, you are telling your body that more milk is needed and the ration needs to be adapted. All of what you removed, the 80 + 20 now becomes the new 80% and an additional 20% on top of that is produced. Thus increasing your supply)

Pumping between nursing sessions. (Keep in mind that hand expressing is more effective than pumping)

Read more about the science behind milk production and how your breasts actually make milk by clicking here.

You might also be tempted to try some of the following options;

Taking medications to increase your production - These are only effective directly after birth when your supply is still hormone driven and also only for a couple of days.

Taking fenugreek or other milk making foods - These are called galactogogues and while they are said to aid in milk production, they won't do anything if the demand is not increased.

Jungle Juice - Jungle juice contains no galactogogues and works purely on the placebo effect. The high sugar content also often leads to Thrush, a very painful condition.

Drinking x amount of water - While it is important to keep yourself hydrated, there is no magic number of liters you should be consuming per day. You only need yo drink to thirst.

Eating a perfect diet - The diet you follow does not impact your quality or quantity of milk and breastfeeding mothers can follow any diet and eat any foods they want.

Don't stress - Many mothers believe that stress makes their milk dry up. This is not true. Stress can inhibit the let-down reflex meaning the milk takes longer to come out but it's all still there.

For a list of all the milk making foods and to learn more about galactogogues, click here.

The key to increasing your production lies in the way your breasts work. In the supply and demand system. If you increase the demand, you increase the supply.